title: Association between periodontal pathogens and risk of nonfatal myocardial infarction.
abstract: BACKGROUND
  The direct effect of periodontal pathogens on atherosclerotic plaque development has been suggested as a potential mechanism for the observed association between periodontal disease and coronary heart disease, but few studies have tested this theory.
  
  
  OBJECTIVE
  (i) To assess the association of periodontal pathogens in periodontal pockets with the risk of myocardial infarction (MI) and (ii) to assess whether an increase in the number of periodontal bacterial species increases the risk of MI.
  
  
  METHODS
  A total of 313 cases and 747 controls, consisting of Caucasian men and women from Western New York, aged 35 to 69 years, were recruited for this study. The presence of microorganisms was assessed by indirect immunofluorescence microscopy, using species-specific polyclonal and monoclonal serodiagnostic reagents. The presence of six periodontal pathogens, Porphyromonas gingivalis (Pg), Tannerella forsythensis (Tf), Prevotella intermedia (Pi), Campylobacter recta (Cr), Fusobacterium nucleatum (Fn), and Eubacterium saburreum (Es), and their co-occurrence (0-6) was compared with the odds of having myocardial infarction.
  
  
  RESULTS
  Univariate analyses revealed a higher percentage of the presence of each bacterium in cases compared to controls. In multivariate analyses, only Tf and Pi were statistically associated with an increase in the odds of having MI [Odds ratio OR=1.62; 95% CI (1.18-2.22); and 1.40; 95% (1.02-1.92), respectively] after adjusting for age, gender, education, cholesterol, high blood pressure, diabetes, and total pack-years of cigarette smoking. An increase in the number of different periodontal bacteria in pockets was also found to increase the odds of MI [adjusted OR=1.14; 95% CI (1.03-1.26)]. Participants who had three species or more of periodontal pathogens had about 2-fold increase in odds of having nonfatal MI than those who did not have any type of bacterial species [OR=2.01 (1.31-3.08)].
  
  
  CONCLUSIONS
  The presence of periodontal pathogens, specifically Tf or Pi, and an increase in total burden of periodontal pathogenic species were both associated with increased odds of having MI. However, further studies are needed to better assess any causal relationship, as well as the biological mechanisms underlying this association.
authors.affiliation: Center for Clinical Research and Health Promotion, University of Puerto Rico, PR. oelisoa.andriankaja@gmail.com
authors.forename: Oelisoa
authors.initials: O
authors.lastname: Andriankaja
authors.forename: Maurizio
authors.initials: M
authors.lastname: Trevisan
authors.forename: Karen
authors.initials: K
authors.lastname: Falkner
authors.forename: Joan
authors.initials: J
authors.lastname: Dorn
authors.forename: Kathleen
authors.initials: K
authors.lastname: Hovey
authors.forename: Sreenivasa
authors.initials: S
authors.lastname: Sarikonda
authors.forename: Tania
authors.initials: T
authors.lastname: Mendoza
authors.forename: Robert
authors.initials: R
authors.lastname: Genco
mesh_terms: D000328:Adult; D000368:Aged; D016866:Bacteroidaceae Infections / Q000150:complications; D002169:Campylobacter Infections / Q000150:complications; D044883:Campylobacter rectus; D016022:Case-Control Studies; D016001:Confidence Intervals; D005260:Female; D005674:Fusobacterium Infections / Q000150:complications; D016967:Fusobacterium nucleatum; D006801:Humans; D008297:Male; D008856:Microscopy, Fluorescence; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000453:epidemiology / Q000209:etiology*; D016017:Odds Ratio; D010514:Periodontal Pocket / Q000150:complications / Q000382:microbiology*; D010518:Periodontitis / Q000150:complications / Q000382:microbiology; D016966:Porphyromonas gingivalis; D018713:Prevotella intermedia; D012307:Risk Factors